Possible AS+ crohns (with thyroid involvement) Stressed and confused

HI Everyone..

kind of a long story, so please bear with me and provide your inputs..

I am 37 yrs old Male with indian decent living in US and have been going through some very odd behavior in the last 5 years

4.5 years back (early 2010) , i started getting low grade fever (at age 32-33). The fever continued for 1.5 months during which the doctors ran all kind of infectious disease test and did not find anything. Near the end of the 1.5 months, i started getting pain in my throat and they ran a thyroid test which showed that my thyroid was inflamed and i was hyper thyroid. This lasted for few daya after which the fever went away and i became hypothyroid-- was given Levoxy 75mcg. I still take this..

This also changed by BM, I used to be very regular before but i started getting more BMs. At the same time, i started getting some pain in my hip join/tail bone whch was not very severe.used to come and go maybe like 2-3 days a month. I also started having some uriniary hesitation issues mostly in the night time. Bladder does not empty fully..

In December of 2010, while travelling to asia, i ate something which caused my nasty dysentery which lasted 2-3 days afyer whcih the dysentery went away but for about 2 months, i got GERD, lot of GAS, 4-5 BMS a day. NO severe stomach pain. I went to a GI and he did a endoscopy and said everything looks fine. The GERD went away but my stomach since then has not been normal with 4-5 BMS a day and lot of Gas (no smell) in the night time)..My buttock/tail bone pain still continued ON and OFF 4-5 time a month) sometime going to neck/shoulder/shoulder blade. Never very severe for me to miss work or anything but bothersome..I also have a computer job so my GP mentioned that posture could be the reason for the pain. For my stomach issues and i went to the GI who said since your BMs have no blood/and are not very loose, it could be IBS..


Come June 2014, i started getting a very severe pain in my stomach (about an inch above my belly button). BMs-5-6 time/day. Still no blood but mucos present. I went to the GI (who was so busy that i could not get any appointment for 1.5 months) and he tried to brush me off again but i insisted we do a endoscopy and colonoscopy and blood test. The pain went away before the colonoscopy. I also developed a small sore in my mouth which lasted about a month..

I also got a Xray of my back done after the colonoscopy since my back was bothering adnd they found some inflammation in the sacrolliac joint (SI Joint). The radiologist comment on the xray was abnormal SI joint, maybe sacacrolottis, Recommend MRI for more investigation. . My ortho did not order a MRI but with physical exam mentioned that the spine looks fine with good gaps between the vertebrae though the found the muscles to be very tight and recommended Physical therapy for 2 months.

Colonoscopy/blood test findings:
0. Slightly raised C reactive protein
1. One small polyp found and removed (was pre cancerous per the biopsy. GI recommended repeat Colonoscopy in 5years))
2. Apothous erosions found in TI (3-4 instances) Biopsy does not show long term inflammation

During meeting with the GI to discuss the Colonoscopy results, he was still not sure if it is IBD but nce i mentioned the SI joint inflammation, he got serious and recommended rheumatologist who he said may put me on Humira. Says it looks like AS (with mild crohns) (i am HLAb27 +ve) He also started course of UCRIS for 2 months...I have the appt with the rhemi next week. GI also ordered MRI of small intestine.. (to be done next week)

this all happened in the last 10 days. I have been a mental wreck since. I know feel pain in my ankle, have strange muscle spasm in my legs, and my back is hurting more.. I am not sleeping well and not sure if the stress is causing some of these issues. Also i am very academic so have started reading all kind of papers and medical studies which are making me more nervous..I have also lost about 14lbs in the last 3 months. Going on Humira is scarring me.

has anyone else gone through a similar course? Thyroid involvement with bowl movement changes//back pain and urinary hesitation..Am i getting misdiagnosed by any chance . what could be the differential diagnosis..

thanks for reading and hoping for some feedback..

Just wanted to welcome you, Sorry for all the uncertainty.
I like to tag in Maya142, she's know all to well about this.
her husband and 2 daughters have AS and one of her dd also have Crohn's.

Though there are other causes of sacroilitis, the fact that you're HLA B27+ and have mild Crohn's pretty much makes it definitely AS or perhaps some other spondyloarthropathy. The course of disease sounds like of life Reactive Arthritis, which occurs after you get an infection. The Spondylitis Association of America website has a lot of good information about the different spondyloarthropathies (AS is one of them).

My younger daughter has both AS and Crohn's. Her Crohn's is mild and but her AS is pretty severe. Both my daughters have been on biologics for years. They haven't really had any side effects - in fact, the biologics have been pretty miraculous for both of them. The older one is in college now and is doing so well that she is essentially a normal college student. The younger one has had a harder time but seems to be improving (very slowly).

It's important to treat AS aggressively, because you don't want any more joint damage or for your spine to fuse. That's why Humira was suggested. Both my daughters have been on Humira - my older daughter is still on it and is doing great! My husband also has AS and since the biologics were not available, was mostly treated with NSAIDs. He has had multiple hip replacements, but is in remission now.

Muscle spasms can be caused by inflammation. My daughters take Flexeril when they have them.
Good luck! This site has a lot of good information, look around!